Many of the specific issues that the Governor and the Legislature asked the Commission to review have festered because the [California] Acupuncture Board has often acted as a venue for promoting the profession rather than regulating the profession.

On March 12, 2012, during a brief Sunset Review hearing, the California Senate Committee on Business, Professions and Economic Development asked the California Acupuncture Board (the Board) to respond to a set of harsh criticisms.

It is not the first time that the dysfunctional Board — which falls under the Department of Consumer Affairs — is being scrutinized by the legislator. The Board has a long history of operating in an inefficient manner, misreading its governing statutes, and potentially endangering the public by refusing to promulgate regulations concerning the sterilization of acupuncture needles or the wear of medical gloves by practitioners.

In the past, members and affiliates have even been investigated for taking bribes and selling licensing exam answers. The Board was replaced several times in order to clean up the quasi-anarchic and corrupt practice of acupuncture and Oriental medicine in California.

This time, the Senate Committee listed 10 major issues in a Background Paper, which is a worthwhile read for those interested in the regulation of acupuncture. The Senate expressed serious concerns about many administrative, educational, licensing, enforcement, consumer protection and budgetary matters. In response, the Board Chair and Executive Director offered little explanation. The Board now must respond to the Background Paper in specifics.
Trouble at the state acupuncture regulating authority goes back to 1982. The longtime chairman of the former acupuncture regulating agency (the Acupuncture Committee), Chae Woo Lew, was selling the answers to the California Acupuncture Licensing Examination for $10,000 to $20,000. He made $500,000 to $800,000 from an estimated 80 test takers. He was caught in 1988, but only a few dozen individuals who bought answers from him were ever caught. Lew was sentenced in 1990 to five years in prison.

In 1999 Acupuncture Committee became the Acupuncture Board. The Board was sunrisen until June of 2002.

During the 2002 sunset review of the Board, an independent state oversight agency called the Little Hoover Commission (LHC) was charged to assess longstanding and contentious issues regarding the State’s regulation of acupuncture — including a review of the scope of practice and educational requirements for acupuncturists, the process for accrediting acupuncture schools and for examining licensees.

LHC provided its assessment to the Legislature in September 2004 in a report called Regulation of Acupuncture: A Complementary Therapy Framework, (Report #175). LHC blamed the Board for many of the problems the profession faced. The report stated that the Board had “too frequently acted as a venue for promoting rather than regulating the profession.” It added that as a result, the Board had “missed opportunities to protect the public by providing accurate and complete information about the therapies that licensees can provide.” The report also stated that the Board had not “adequately incorporated emerging scientific evidence into board policies, regulations and public communications.”

The following Board review in 2005 found little improvements. Among the main concerns was the fact that the Board had misread its governing statutes concerning the scope of practice of acupuncturists. It also pointed out that the Board had potentially endangered the public by refusing to promulgate regulations concerning the sterilization of needles or even to discuss this issue as an agenda item in any public meeting.

During the most recent Board review, the Senate committee pointed out that most of the current issues are the same as those the former sunset review committees had struggled with. The persistence of these issues appears to indicate a general lack of accountability and follow-through on the part of the Board, making one wonder if there is a real willingness to take direction from the Legislature and to implement its recommendations.

The March 12, 2012, hearing ended with the Senate Committee letting the Board’s Chair and Executive Director know that it was very concerned about how the Board operates.

One of the persisting issue is the Board’s insufficient oversight of continuing education units (CEUs) . The Board has consistently approved material that is “grossly out of compliance” with it own regulations. The Senate Committee gave examples of courses in numerology, vitalism, astrology, “the Capacity and Function of Love,” cosmology, magic, sound healing with tuning forks; Reiki and “Four Energy Healing Theories,” whatever that means.

A 2003 CEU certificate in “Alchemical Acupuncture” taught by Jeffrey C. Yuen. A workshop in such outrageous nonsense is sufficient to renew an active acupuncture license in California.

The Board has indeed a long history of approving CEUs in hocus pocus. Examples are courses in mysticism, Taoism, alchemy, astrology, iridology, magic, geomancy (I-Ching), numerology, etc. The latest list is available here. What is most disturbing is the Board’s continuing denial that there is something wrong with approving a course in subjects such as astrology…

This flyer states in a different section that “This workshop is approved for 21 CEUs in Category 1 by the California State Board.”

After a complaint letter to the Board, its Executive Officer, Janelle Wedge, writes to me that: “Based on the comments received, there is no reason to alter the approval of the course.” Wedge resigned right after the Senate hearing.

Another Senate criticism was the disciplinary case management time-frame. The Board, which is responsible for regulating the practice of approximately 10,000 acupuncturists, takes at least 2½ years to investigate and take action. Since 2008, there has been an average of 223 enforcement cases per year; the majority involve unprofessional conduct, ethical issues, practice management issues and sexual misconduct. A list of disciplinary actions is available at the Board Actions webpage. The Board has received an average of 145 direct complaints complaints per year since 2008. It has also received 78 arrest/conviction reports from law enforcement since 2008.

And arrest and conviction there is — even for major crimes, such as trafficking in persons and sexual slavery. The media reports that since 2006, 17 people from 10 massage and acupuncture parlors in Redondo Beach, CA, have been arrested for alleged acts of prostitution (The Daily Breeze, Dec 8, 2010). In June 2009, 22 women – most of them Chinese nationals – were arrested in Vista, CA, in connection with 9 day spas and acupuncture clinics (FOX 5 San Diego, June 4, 2009). Prior to that, in March 2007, in one of the largest prostitution investigations ever in Orange County, CA, five individuals were arrested in business that advertised acupuncture and massage but sex was the only service provided.

According to District Attorney Tony Rackauckas, plastic food wraps were used instead of condoms in an acupuncture brothel in Orange County, CA. Photo source: Orange County Register.

Crime at acupuncture and massage parlors is such a concern that some local governments in Southern California have taken their own preventative measures by withholding business licensing. For example, the neighboring cities of Redondo Beach and Torrance have recently passed Urgency Ordinances that impose a moratorium on the issuance of any new permit, license, approval or entitlement pertaining to new massage/bodywork and acupuncture businesses, services and practitioners.

The picture that emerges here based on the Senate review and reports in the media, is that acupuncture in California is a poorly-regulated and corrupt profession with an ill-defined scope of practice. Many practitioners are deluded purveyors of New Age mumbo-jumbo, and a few are criminals involved in human trafficking and prostitution. The dysfunctional Acupuncture Board not only does not protect the public from quacks and criminals, but quite to the contrary, has a long legacy of acting in their favor. None of this serves the best interest of the public.

By looking at this picture, the world “Kafkaesque” comes to my mind. It is the only term that can accurately describe the senseless, disorienting and often menacing complexity of acupuncture regulation in California. The Board’s failure to follow a clear course of action, its unwillingness to implement its mission, the incomprehensible delays in disciplinary actions, and the bizarre and illogical rationale for some of its decisions, all point to the cynical dereliction of public safety by a group of defiant insiders.

A good article that reminds us all of the power of the ballot. It doesn’t matter what you or I or science says…It does matter who your legislators are, because what they say becomes law. Last time I checked, our license to practice in a psarticular manner was issued by the state, for which one paid a fee for the ability to use one’s skills. Jann Bellamy’s recent “Legislative Alchemy 2012.5″ and this post by Kavoussi bring the “possible” into the realm of the “probable.” The antidote? Get involved with your legislators at all levels, encourage professional societies (they have your dues money to pay large sums to lobbyists) and remember that nothing beats personal contact.

I couldn’t help but feel that continuing education in allied hocus pocus fields is what would serve them best in their profession, which is to make money while persuasively reciting gibberish, with theatrics. Gotta keep up on what the competition is doing. Could learn a trick or two. Or get a new side-line. A little naturopathy on the side never hurt the practitioner, and would round out the needling stuff – more holistic.
I’m glad I don’t have to define scope of practice for such stuff. What would I base it on?
At least the Lew guy put the truth right in his name. Maybe licensing boards should require that.

After reading this, what I’m left wondering is: what is the legislature going to do about this? The board clearly has never functioned properly since its very inception. Is the legislature just going to say, “You better clean up your act,” and leave it at that? What about the “or else”? It seems like there is no, nor has there ever been, a reason for the board to actually improve, since the legislature keeps doing the same thing: telling them they need to clean up, then extending their sunset another couple years and repeating the whole process.

At some point, they really need to just say, “Hey. You guys aren’t doing your job. You’ve never done your job. There are no prospects that you ever will do your job. So, no more job.” Get rid of the board and reevaluate the wisdom of licensing acupuncturists in the first place.

The emperor of California is not wearing any clothes and the legislature needs to say so. Sadly, gazillions of Californians (having already soiled their own nest) have migrated to my beloved Pacific Northwest and spread their woo far and wide. Acupuncture is covered by insurance in Oregon if it’s done by an MD! I know because I did it once (a long time ago). It was so lucrative that the Chinese doctor who was doing it had pretty much given up his previous private practice and was doing acupuncture full time.

I went for a massage last time I was home, and was offered the TUNING FORKS mentioned above–“it’s the VIBRATIONS” I was told upon raising my eyebrows. I made it clear that I was not ill, or spiritually needy, and only wanted the massage after a long road trip. I just know that she pitied me for my lack of “spiritualness”.

The California Acupuncture Board (CAB) has long believed and openly stated that it exists to promote the acupuncture profession. In the past two recent public meetings Board members have stated this. I do not think the Board members are in the pockets of the profession although if one wanted to investigate such one would begin with the training programs, the liability carrier, and the herbal companies. However, I doubt this is the case. What is clear based on Board minutes going back years is that the Board does not not understand the following: (1) the mission of EVERY Board under the Department of Consumer Affairs is to PROTECT THE CONSUMER; (2) the mission of EVERY BOARD is three fold – discipline licensees who break the law, approve and monitor the training programs to assure educational quality, and (3) PROTECT CONSUMERS. One cannot really say this enough especially with the CAB which has several members – not all – who fail to comprehend this. In May The CAB was given 8 meetings (2 years) by the Sunset Review Committee to demonstrate they can begin to “function properly” and act in accordance with their mission. The CAB must stop approving schools without any follow-up review AND the CAB must begin to use pass rates on the licensing exam as the #1 criterion for removing schools that are unable to adequately prepare more than half their graduates to pass the state’s licensing exam. Incredible as it seems the average passing rate over the previous DECADE for all acupuncture schools on the state acupuncture licensing exam is 60%. That means 40% of all test takers fail the exam. In every other health profession the passing rate is above 80%. The CAB knows this. They just do not know what to do. They do not know how to function properly.

“An acupuncturist provides health care using acupuncture and other forms of traditional Oriental Medicine. Acupuncture treats neurological, organic or functional disorders by stimulation of specific points on the surface of the body by insertion of needles. Under Oregon law, the practice of acupuncture also includes traditional and modern techniques of oriental diagnosis and evaluation; Oriental massage, exercise and related therapeutic methods; use of Oriental herbs, vitamins, minerals, and dietary advice.” (From ORS 677 and OAR 847-070)

I submit both states have equally insane regulation regarding acupuncture and that a case can be made that since Oregon’s statues are much more broadly-worded, even more wackiness can take place.

Indeed, legislative action seems to be the only way out of this regulatory mess, especially now that the California Senate is aware that the Acupuncture Board is a dysfunctional organization that cannot protect the public. In my opinion, it is just a matter fo time before the legislator shuts down the whole thing, and places the practice of acupuncture under another board.

Yes, like any other form of business, quackery seems to keep up with the competition. Unfortunately there is a market for any type of nonsense. This is because many people do not have the necessary education to distinguish science from voodoo. Most CAM providers prey on desperate and uninformed people, and these courses are there to embellish their strategy.

I fully agree with you. Getting rid of the board and reevaluating the wisdom of licensing traditional acupuncturists seems to be where we are heading. One question remains: what are we going to do with the 10,000 licensed acupuncturists in California? These people cannot transition to any other profession because instead of basic biomedical sciences that have learned hocus-pocus and mambo jambo.

What we need is a class action lawsuit, and compensatory education funds to retrain people.

Yes, many CA acupuncturists have spread the woo-woo beyond our borders and are exporting it to other states. Fortunately in some states there is strong resistance. Many states do not view acupuncturists as CA does and I applaud them.

Keep up the lack of “spiritualness.” It will serve you well in the long-run!

Thank you for your comments and classifications. Have you heard the saying “The wolf was sick, he vowed a monk to be: But when he got well, a wolf once more was he”?

I am afraid if the Board survived the current situation, it will somehow continue to promote woo-woo. Perhaps the best thing is to shut down the dysfunctional Board, as Todd W is suggesting, and reevaluate the wisdom of licensing traditional acupuncturists…

The acupuncture laws in CA and OR are indeed insane. They came to be due to legislative pressure and political action and are written by people who do not have any knowledge of biomedical sciences. They are similar to law regulating homeopathy and naturopathy: legislated nonsense.

I don’t think the prostitution was terribly relevant to your post and in fact I think it would have been better without it. You said it yourself, “a few are criminals.” Better in my opinion to focus on the broader problems that apply to all of them. But overall a good post.

Not many other supposed medical professions are commonly associated with prostitution, and you would think a licensing board with an investigations and enforcement agency would be interested in perhaps revoking a license or just giving a citation for that type of thing. Furthermore, if acupuncturists were truly well-educated and trained professionals you would think the membership would be more interested in these types of issues.

The acupuncture laws in CA and OR are indeed insane. They came to be due to legislative pressure and political action and are written by people who do not have any knowledge of biomedical sciences. They are similar to law regulating homeopathy and naturopathy: legislated nonsense.

I forgot to thank you in my post for this article. I appreciate the history and details about the current state of wackiness and pending legislation. As a Golden State resident I often encounter people who go to an acupuncturist for all sorts of ailments and when they come to find about any ailment I have, heartily recommend either acupuncture in general or their acupuncturist in particular to me.

This sometimes leads to a discussion about acupuncture and me saying that there is no basis to believe it has any foundation in science. They go on to point out ancient wisdom and talk about possible “quantum effects.” I talk about the actual lack of historical evidence to make the practice ancient and and say that even if science discovers some kind of subtle energy field permeating the universe there is no reason to believe such a field can be affected by sticking a stainless steel needle into the body as such a needle is unimaginably, inconceivably larger than any particular area of such a field. Sometimes this works to end an argument but more often than not I am met with their final trump card, usually something like:

“Well, the State of California licenses and regulates it so it must be legitimate and doing some good even if no one really understands how it works.”

So as you say, alas it comes down to the state’s imprimatur through regulated nonsense giving legitimacy to something that should be a chapter in medical history rather than an insurance billable with ICD coding.